带旋髂深血管蒂髂骨瓣移植治疗青壮年股骨颈骨折的疗效观察

目的 探讨切开复位空心钉内固定联合带旋髂深血管蒂髂骨瓣移植术治疗不稳定青壮年股骨颈骨折的手术方法 及疗效.方法 对21例Garden Ⅲ及Ⅳ型青壮年股骨颈骨折采用切开复位空心钉内固定联合带旋髂深血管蒂髂骨瓣移植术治疗.结果 21例全部获随访,时间2年3个月～6年,20例术后均获骨折愈合,髋关节功能恢复良好,定期复查X线片未发现股骨头坏死征象.1例晚期出现股骨头缺血坏死,行人工髋关节置换.结论 切开复位空心钉内固定联合带旋髂深血管蒂髂骨瓣移植术固定可靠,可提供股骨颈骨折后股骨头血运,促进骨折愈合,减少股骨头缺血坏死和骨不连的发生,是治疗青壮年股骨颈骨折的有效方法.

Treatment of femoral neck fracture in young adults by transfering of vascularized bone graft with deep iliac circum flex blood vessel

Objective To investigate the curative effects and the operational methods of instabe femoral neck fracture treated with grafting of ihac bone flap with pedicels of deep circumflex ihac vessels combined with internal fixation with cancellous screws after Open reduction in young adults. Methods Twenty-one cases of femoral neck fracture of Garden III, IV in the young adults were treated by the operation with grafting of iliac bone flap with pedicels of deep circumflex iliac vessels combined with internal fixation with cancellous screws after open reduction. Results The 21 cases after operation were followed up from 2 years and 3 months to 6 years. The 20 cases after operation received union of fracture and a good recovery of function with coxa,which were not detected necrosis of femoral head. The one case was avascular necrosis of femoral head, which was displaced by a hip prosthesis. Conclusion The operational method of grafting of iliac bone flap with pedicels of deep circumflex iliac vessels combined with internal fixation with cancellous screws after open reduction was an effective treatment to femoral neck fracture in the young adults, it could give a safe internal fixation, offer blood for the femoral head which suffered femoral neck fracture, elevate the percentage of union of fracture and reduce the percentage of avascular necrosis of the femoral head.